Hip replacement surgery



Hip replacement surgery


Our hips are naturally protected when we’re young. Large muscles surround our hip, and smooth cartilage covers our bone surfaces to cushion the ball and socket joint. But over time and with use, the bones in our hip joints can wear or become damaged.

Normal wear and tear, fractures and bone death from a lack of blood supply all contribute to osteoarthritis, also called degenerative joint disease, the main cause of cartilage breakdown in the hip. When your hip cartilage wears away, the bones in your hip joint start to rub against each other. This causes your hip to become stiff and painful, eventually creating bone spurs and other deformities.

Here we cover non-surgical and surgical options for treating a painful or immobile hip joint. You’ll also gain a better understanding of how each type of total hip replacement surgery works and what to expect for recovery.

What is a total hip replacement surgery?

During total hip replacement surgery, the damaged joint is replaced with an artificial joint using one of a variety of prostheses. There are four types of total hip replacement surgery. You’ll find an overview of each below. Your surgeon can help you decide which surgical or non-surgical treatment option is best for you.

What are my alternatives to hip replacement surgery?

Hip replacement surgery isn’t always the best option for treating hip pain or problems with mobility. In some cases, a doctor might recommend:

  • Limiting your activities, particularly those that cause hip pain
  • Physical therapy
  • Anti-inflammatory medications
  • Assistive devices like a cane or rollator (walker)
  • Chondroitin sulfate
  • Glucosamine
  • Cortisone injections in the hip (including intra-articular, ultrasound-guided injections)
  • Weight loss program

Types of total hip replacement surgeries

The type of procedure that offers the best results will depend on your situation. Types of total hip replacement surgeries include:

  • Partial hip replacement
  • Posterior hip replacement
  • Anterior hip replacement
  • Anterolateral hip replacement
  • SUPERPATH hip replacement
  • Revision hip replacement

Partial hip replacement surgery

With a partial hip replacement, only half of the hip joint is replaced. During this procedure, the surgeon replaces the thigh bone and femoral ball with prosthetic components. But unlike with a total hip replacement, the hip socket stays intact.

Traumatic hip injuries like fractures can limit the amount of blood that flows to the femoral head. This may lead to early bone death, pain and loss of mobility. Surgeons usually recommend partial hip replacement surgery for repairing specific types of hip fractures. Candidates for partial hip replacement surgery will typically have healthy cartilage in their hip joint and minimal signs of arthritis.

Recovering from partial hip replacement surgery: what to expect

The recovery process for a partial hip replacement is similar to that of a total hip replacement. But because both natural and prosthetic components are involved, the recovery timeline tends to be a bit longer. You should be able to walk without a supportive device within three to four weeks after surgery. Expect it to take about six to eight weeks before you can resume normal household activities.

You may experience mild pain and swelling for three to four months after the procedure. Full recovery can take up to six months, however some patients are able to resume recreational activities within six weeks.

Total hip replacement surgery

In a total hip replacement, the head and neck of the femur are removed to provide access to the acetabulum (hip socket). The surgeon then removes damaged cartilage from the hip socket and places a new metal socket. Next, a liner or bearing made of plastic or ceramic is inserted into the socket. This allows for a smooth, gliding motion between the new ball and socket.

Once the liner is in place, the bone of the femur is hollowed out to make room for the implant stem, which is cemented or press-fit into the thigh bone. Finally, a ceramic or metal ball is attached to replace the head of the femur.

Recovering from total hip replacement surgery: what to expect

Total hip replacement surgery is a major operation however in some cases it does not require an overnight stay. Most patients are able to walk the day of surgery.

Exercise plays a big role in recovery. Your physical therapist may recommend a progressive walking program along with other exercises designed to restore strength and movement. It normally takes about three to six weeks to resume normal household activities, about 12 weeks to resume recreational activities like bicycling or golfing. For some patients it can take six months to a year to fully recover from a total hip replacement.

Posterior hip replacement surgery

During this procedure, the patient is positioned on their side and the incision is made in the posterior, or just behind the hip. Posterior hip replacement is the most common total hip replacement because it provides the best patient safety. Most patients are candidates for this procedure.

Recovering from posterior hip replacement surgery: what to expect

Some patients return home and begin rehabilitation the day of surgery. Most return home within a day or two.

Patients can expect to walk using an assistive device within a day and to resume most normal household activities within a few weeks, though recovery times vary. Though this procedure is considered slightly more invasive than an anterior hip replacement, there tends to be little difference in recovery progress three months after surgery.

Anterior hip replacement surgery

This procedure is considered minimally invasive because there’s a small incision (about 3 – 4 inches) and no major muscles or tendons need to be detached or cut. With the patient on their back, the surgeon replaces the hip through the anterior, or front, where there’s room to work around muscles and tendons. An anterior hip replacement is also called a muscle-sparing hip replacement.

Those with fragile bones and people who are muscular or obese may not be candidates for anterior hip replacement surgery. Talk to your surgeon about the best option for you.

Recovering from anterior hip replacement surgery: what to expect

Because muscles and tendons surrounding the hip are “spared” during this procedure, patients can expect fewer mobility restrictions and shorter recovery times compared to other hip replacement approaches. Patients usually experience less pain and have fewer physical therapy requirements following this procedure as well.

Most patients return home the day after surgery. Some go home the same day.. Nearly all patients are able to walk using an assistive device within a day. Patients can expect to return to work in about a month however this timeline may be longer if your job calls for a lot of standing, walking or heavy lifting. While the recovery timeline tends to be shorter, the long-term results are similar to other total hip replacement approaches.

Anterolateral hip replacement surgery

Similar to an anterior hip replacement, this surgery is generally performed with the patient lying on their back. The patient’s buttock is positioned near the edge of the table. This way, when the surgeon makes the small incision, fat falls away from it. The main difference between an anterior hip replacement and an anterolateral hip replacement is where the incision is made. In an anterolateral hip replacement, the incision is made in the intramuscular plane between the gluteus and thigh muscles. The anterior incision is closer to the front of the hip; the posterior incision is closer to the back (below).

image of hip anterior posterior

Image credit

Since this surgery doesn’t disrupt soft tissues in the posterior, it’s commonly used when there’s risk of dislocation. Obese patients and shorter, more muscular men may not be candidates for this surgery.

Recovering from Anterolateral hip replacement surgery: what to expect

A study comparing recovery times for anterior and anterolateral total hip replacement patients found that anterior patients tend to function slightly better than anterolateral in the weeks immediately following surgery. The study also found that neither approach provided a faster overall recovery, however.

SuperPATH hip replacement surgery

This surgery is similar to an anterior hip replacement in that they’re both “tissue-sparing.” The key difference is what happens inside, where muscles surround and attach to the hip. The SuperPATH approach (Supercapsular Percutaneously Assisted Total Hip) allows the surgeon to work inside the bone, meaning no tendons are cut and less tissue is damaged. There isn’t a single, step-by-step process for SuperPATH hip replacement surgery – the approach is adjusted for each patient to produce the best results with the least invasiveness.

Recovering from SuperPATH hip replacement surgery: what to expect

SuperPATH is generally considered to be the least invasive type of hip replacement surgery. Because tendons and tissues surrounding the hip aren’t cut or stretched as much, the new hip is said to feel more natural. Patients can often walk within a few hours of surgery.

Compared to other total hip replacement surgeries, SuperPATH patients tend to return home sooner, have fewer complications and don’t need as much medicine to manage pain. There are no hip position restrictions and most patients can expect to walk without a supportive device within a few weeks, at which point it may be safe to resume the physical activities you enjoy. Be sure to check with your doctor or physical therapist about which activities are safe and which to avoid.

Revision hip replacement surgery

Similar to how our natural hip bones experience wear and tear, the original components used in a hip replacement can also break down. When this happens, a surgeon may recommend revision hip replacement surgery to exchange the worn components with new ones.

Recovering from revision hip replacement surgery: what to expect

The complexity of revision surgery varies based on how loose the components have become and how much damage has occurred as a result. Your surgeon will be able to provide a clearer recovery timeline based on the specifics of your procedure.

What makes TRIA a top destination for total hip replacement surgery?

You won’t be pushed toward surgery. You’ll get an accurate diagnosis and expert answers to help you decide what’s best for you. Whenever possible, we recommend treatment options to help you avoid surgery.

Hospital, hotel or at home – choose your recovery option. Most patients choose to go straight home after surgery if they meet the criteria and their insurance covers it. Others opt for the Hotel Recovery Program and receive care in an environment that’s quieter and more comforting than a traditional hospital room. There’s no out-of-pocket cost with hotel recovery and it’s less expensive than a hospital stay.

Confidence. Choose from surgeons considered among the best not just in Minnesota, but the entire Midwest. One year after surgery, 96% of our patients report walking with little to no hip pain.

Ready to explore your options? We’re here to answer all of your questions.

Transform hip pain from everyday reality to distant memory

Most people living with hip pain don’t have to accept it as “part of life” or “part of aging.” If you’d like to learn more about what you can do about it, schedule an appointment online or call 952-831-8742.

Looking for a second opinion?

Whether you want a second opinion from someone else or you want us to provide one, the important thing is to get the answers you need to make the best decision for you. In many cases, insurance will cover the second opinion (check with your provider to be sure).

To schedule a second opinion for hip replacement surgery, call 952-831-8742.

Hip Specialists & Surgeons:

Kirk Aadalen, MD

Timothy Gabrielson, MD

Patrick Horst, MD

Der-Chen Huang, MD

Patrick Morgan, MD

Gavin Pittman, MD

Christine Pui, MD

Mark Thomas, MD